Role of community pharmacists in patients' self-care and self-medication

Paul Rutter, Paul Rutter

Abstract

This review highlights the growing prominence of self-care and explores the contribution of community pharmacy. Firstly, background to self-care is discussed, followed by placing self-care in context with regard to the general public and accessing community pharmacy. From this perspective the contribution community pharmacy currently makes is assessed, paying particular attention to the factors that negatively impact on the ability of community pharmacy to facilitate self-care.

Keywords: community pharmacy; disease prevention; health belief; health maintenance; health promotion.

Conflict of interest statement

Disclosure The author declares no conflicts of interest in this work.

Figures

Figure 1
Figure 1
The self-care continuum. Note: Copyright © 2015. Reproduced from the Self Care Forum.

References

    1. Webber D, Guo Z, Mann S. Self-care in health: we can define it, but should we also measure it? Self Care. 2013;4(5):101–106.
    1. World Health Organization (WHO) Regional Office for South-East Asia . Self-care in the Context of Primary Health Care: Report of the Regional Consultation Bangkok, Thailand, 7–9 January 2009. New Delhi: WHO Regional Office for South-East Asia; 2009. [Accessed January 31, 2015]. Available from: .
    1. Blaxter M. Health and Lifestyles. London and New York, NY: Routledge; 1990.
    1. Nettleton S. The Sociology of Health and Illness. Cambridge: Polity Press; 2006.
    1. Mechanic D. Medical Sociology. 2nd ed. New York, NY: Free Press; 1978.
    1. Monaghan LF. Looking good, feeling good: the embodied pleasures of vibrant physicality. Sociol Health Illn. 2001;23(3):330–356.
    1. Scambler G. Sociology as Applied to Medicine. 5th ed. Edinburgh: Saunders; 2003. p. 1.
    1. World Self-Medication Industry (WSMI) Responsible Self-Care and Self-Medication: A Worldwide Review of Consumer Surveys. Ferney-Voltaire: WSMI; [Accessed February 9, 2015]. nd. Available from: .
    1. Nichol MB, McCombs JS, Johnson KA, Spacapan S, Sclar DA. The effects of consultation on over-the-counter medication purchasing decisions. Med Care. 1992;30(11):989–1003.
    1. Sclar DA, Robison LM, Skaer TL. Pharmacy consultation and over-the-counter medication purchasing outcomes. Over-the-Counter Medication Intervention Project Team. J Clin Pharm Ther. 1996;21(3):177–184.
    1. Coons SJ. The pharmacist’s role in promoting and supporting self-care. Holist Nurs Pract. 1990;4(2):37–44.
    1. Aronson JK. Compliance, concordance, adherence. Br J Clin Pharmacol. 2007;63(4):383–384.
    1. Barry MJ, Edgman-Levitan S. Shared decision making – pinnacle of patient-centered care. N Engl J Med. 2012;366(9):780–781.
    1. Covington TR. The pharmacist as nonprescription drug therapy manager: let’s seize the opportunity. J Am Pharm Assoc (Wash) 2002;42(3):518–519.
    1. Tisman A. The Rising Tide of OTC in Europe: Trends, Challenges and New Potential in a Rapidly Evolving Market. Norwalk, CT: IMS Health; 2010. [Accessed January 23, 2015]. Available from: .
    1. Martins AP, da Costa Miranda A, Mendes Z, Soares MA, Ferreira P, Nogueira A. Self-medication in a Portuguese urban population: a prevalence study. Pharmacoepidemiol Drug Saf. 2002;11(5):409–414.
    1. Chui WK, Li SC. Advice-giving on self-medication: perspectives of community pharmacists and consumers in Singapore. J Clin Pharm Ther. 2005;30(3):225–231.
    1. Proprietary Association of Great Britain (PAGB) A Summary Profile of the OTC Consumer. London: PAGB; 2005. [Accessed April 8, 2015]. Available from: .
    1. Banks I. Self care of minor ailments: a survey of consumer and healthcare professional beliefs and behaviour. Self Care. 2010;1(1):1–13.
    1. Hassali MA, Shafie AA, Al-Qazaz H, Tambyappa J, Palaian S, Hariraj V. Self-medication practices among adult population attending community pharmacies in Malaysia: an exploratory study. Int J Clin Pharm. 2011;33(5):794–799.
    1. Gray NJ, Cantrill JA, Noyce PR. ‘Health repertories’: An understanding of lay management of minor ailments. Patient Educ Couns. 2002;47(3):237–244.
    1. Thomas DH, Noyce PR. The interface between self medication and the NHS. BMJ. 1996;312(7032):688–691.
    1. Akesson C, Paulos C, Marin F, Salazar C. A description of patients presenting with minor illness in community pharmacies in southern Chile. Int J Pharm Pract. 2007;15(2):123–128.
    1. Cantrill J, Morris C, Weiss M. How patients perceive minor illness and factors influencing seeing a doctor. Prim Health Care Res Dev. 2006;7(2):157–164.
    1. Cornford CS. Why patients consult when they cough: a comparison of consulting and non-consulting patients. Br J Gen Pract. 1998;48(436):1751–1754.
    1. Wyke S, Hewison J, Russell IT. Respiratory illness in children: what makes parents decide to consult? Br J Clin Pract. 1990;40(335):226–229.
    1. Stoller EP, Forster LE, Portugal S. Self-care responses to symptoms by older people. A health diary study of illness behavior. Med Care. 1993;31(1):24–42.
    1. Blumenthal D, Davis K, Guterman S. Medicare at 50 – moving forward. N Engl J Med. 2015;372(7):671–677.
    1. Black N. Can England’s NHS survive? N Engl J Med. 2013;369(1):1–3.
    1. Keyhani S, Falk R, Howell EA, Bishop T, Korenstein D. Overuse and systems of care: a systematic review. Med Care. 2013;51(6):503–508.
    1. Marchildon G. Canada: Health system review. Health Syst Transit. 2013;15(1):1–179.
    1. Ministry of Health . Better, Sooner, More Convenient Health Care in the Community. Wellington: Ministry of Health; 2011. [Accessed February 17, 2015]. Available from: .
    1. National Health Service (NHS) England . Transforming Urgent and Emergency Care Services in England: Urgent and Emergency Care Review End of Phase 1 Report; High Quality Care for All, Now and for Future Generations. London: NHS England; 2014. [Accessed February 16, 2015]. Available from: .
    1. PAGB . Unlocking Self Care: PAGB Annual Review 2008. London: PAGB; 2008.
    1. Pillay N, Tisman A, Kent T, Gregson J. The economic burden of minor ailments on the National Health Service (NHS) in the UK. Self Care. 2010;1(3):105–116.
    1. Bednall R, McRobbie D, Duncan J, Williams D. Identification of patients attending accident and emergency who may be suitable for treatment by a pharmacist. Fam Pract. 2003;20(1):54–57.
    1. Pharmacy Research UK . Community Pharmacy Management of Minor Illness: MINA Study. London: Pharmacy Research UK; 2013. [Accessed February 17, 2015]. (Final Report). Available from: .
    1. Pharmacists near top of “most trusted profession” poll. Pharm J. 2009;282:472.
    1. Cohen JP, Paquette C, Cairns CP. Switching prescription drugs to over the counter. BMJ. 2005;330(7481):39–41.
    1. Harrington P, Shepherd MD. Analysis of the movement of prescription drugs to over-the-counter status. J Manag Care Pharm. 2002;8(6):499–508.
    1. Lipsky MS, Waters T. The “prescription-to-OTC switch” movement. Its effects on antifungal vaginitis preparations. Arch Fam Med. 1999;8(4):297–300.
    1. Lynd LD, Taylor J, Dobson R, Willison DJ. Prescription to over-the-counter deregulation in Canada: are we ready for it, or do we need to be? CMAJ. 2005;173(7):775–777.
    1. Soller RW. Evolution of self-care with over-the-counter medication. Clin Ther. 1998;20(Suppl C):C134–C140.
    1. WSMI . Switch: Prescription to Non-Prescription Medicines Switch. Ferney-Voltaire: WSMI; 2009. [Accessed March 23, 2015]. Available from: .
    1. Brown D, Portlock J, Rutter P, Nazar Z. From community pharmacy to healthy living pharmacy: positive early experiences from Portsmouth, England. Res Social Adm Pharm. 2014;10(1):72–87.
    1. Paudyal V, Watson MC, Sach T, et al. Are pharmacy-based minor ailment schemes a substitute for other service providers? A systematic review. Br J Gen Pract. 2013;63(612):e472–e481.
    1. Department of Health . Pharmacy in England: Building on Strengths – Delivering the Future. Norwich: The Stationery Office; 2008. [Accessed February 17, 2015]. (Cm 7341). Available from: .
    1. Canadian Pharmacists Association (CPhA) Task Force on a Blueprint for Pharmacy . Blueprint for Pharmacy: Designing the Future Together. Ottawa, ON: CPhA; [Accessed February 17, 2015]. p. 2008. Available from:
    1. Pharmacy Sector Action Group . Focus on the Future: Ten-Year Vision for Pharmacists in New Zealand; 2004–2014. Wellington: Pharmaceutical Society of New Zealand; 2004. [Accessed February 17, 2015]. Available from: .
    1. National Center for Chronic Disease Prevention and Health Promotion . Guide for Public Health: Partnering with Pharmacists in the Prevention and Control of Chronic Diseases. Atlanta, GA: Centers for Disease Control and Prevention; 2012. [Accessed February 17, 2015]. Available from: .
    1. Farris KB, Schopflocher DP. Between intention and behavior: an application of community pharmacists’ assessment of pharmaceutical care. Soc Sci Med. 1999;49(1):55–66.
    1. Tsuyuki RT, Schindel TJ. Leading Change in Pharmacy Practice: Fully Engaging Pharmacists in Patient-Oriented Healthcare. Edmonton, AB: University of Alberta Centre for Community Pharmacy Research and Interdisciplinary Strategies; 2004. [Accessed April 9, 2015]. Available from: .
    1. Bradley F, Elvey R, Ashcroft D, Noyce P. Commissioning services and the new community pharmacy contract: (2) Drivers, barriers and approaches to commissioning. Pharm J. 2006;277:189–192.
    1. Bradley F, Elvey R, Ashcroft D, Noyce P. Commissioning services and the new community pharmacy contract: (3) Uptake of enhanced services. Pharm J. 2006;277:224–226.
    1. Scahill SL, Carswell P, Harrison J. An organizational culture gap analysis in 6 New Zealand community pharmacies. Res Social Adm Pharm. 2011;7(3):211–223.
    1. Willink DP, Isetts BJ. Becoming ‘indispensable’: developing innovative community pharmacy practices. J Am Pharm Assoc (2003) 2005;45(3):376–386.
    1. Roberts AS, Benrimoj SI, Chen TF, Williams KA, Aslani P. Practice change in community pharmacy: quantification of facilitators. Ann Pharmacother. 2008;42(6):861–868.
    1. Pharmaceutical Services Negotiating Committee (PSNC) MUR statistics [web page on the Internet] London: PSNC; 2015. [Accessed February 4, 2015]. Available from:
    1. Rogers EM. Diffusion of Innovations. 5th ed. New York, NY: Free Press; 2003.
    1. Rosenthal M, Austin Z, Tsuyuki RT. Are pharmacists the ultimate barrier to pharmacy practice change? Can Pharm J (Ott) 2010;143(1):37–42.
    1. Pfleger DE, McHattie LW, Diack HL, McCraig DJ, Stewart DC. Views, attitudes and self-assessed training needs of Scottish community pharmacists to public health practice and competence. Pharm World Sci. 2008;30(6):801–809.
    1. Bryant LJM, Coster G, Gamble GD, McCormick RN. General practitioners’ and pharmacists’ perceptions of the role of community pharmacists in delivering clinical services. Res Social Adm Pharm. 2009;5(4):347–362.
    1. Paudyal V, Hansford D, Cunningham S, Stewart D. Over-the-counter prescribing and pharmacists’ adoption of new medicines: diffusion of innovations. Res Social Adm Pharm. 2013;9(3):251–262.
    1. Anderson C, Alexander A. Response to dysmenorrhoea: an assessment of pharmacists’ knowledge and its application in practice. Int J Pharm Pract. 1993;2(3):180–183.
    1. Krska J, Greenwood R, Howitt EP. Audit of advice provided in response to symptoms. Pharm J. 1994;252:93–96.
    1. Krska J, Kennedy E. Responding to symptoms: Comparing general practitioners and pharmacists’ advice. Pharm J. 1996;257:322–324.
    1. Krska J, Kennedy EJ. An audit of responding to symptoms in community pharmacy. Int J Pharm Pract. 1996;4(3):129–135.
    1. Morris CJ, Cantrill JA, Weiss MC. “One simple question should be enough”: consumers’ perceptions of pharmacy protocols. Int J Pharm Pract. 1997;5(2):64–71.
    1. Morrow N, Hargie O, Donnelly H, Woodman C. “Why do you ask?” A study of questioning behaviour in community pharmacist-client consultations. Int J Pharm Pract. 1993;2(2):90–94.
    1. Consumers’ Association Pharmacists: how reliable are they? Which Way to Health? 1991;12:191–194.
    1. Consumers’ Association Vital checks are still not being made. Which Way to Health? 1994;12:196.
    1. Consumers’ Association Counter advice. Which Way to Health? 1999;3:22–25.
    1. Lamsam GD, Kropff MA. Community pharmacists’ assessments and recommendations for treatment in four case scenarios. Ann Pharmacother. 1998;32(4):409–416.
    1. Rutter PM, Horsley E, Brown DT. Evaluation of community pharmacists’ recommendations to standardized patient scenarios. Ann Pharmacother. 2004;38:1080–1085.
    1. Driesen A, Vandenplas Y. How do pharmacists manage acute diarrhoea in an 8-month-old baby? A simulated client study. Int J Pharm Pract. 2009;17(4):215–220.
    1. Bilkhu P, Wolffsohn JS, Taylor D, Gibson E, Hirani B, Naroo SA. The management of ocular allergy in community pharmacies in the United Kingdom. Int J Clin Pharm. 2013;35(2):190–194.
    1. Tucker R, Patel M, Layton AM, Walton S. An examination of the comparative ability of primary care health professionals in the recognition and treatment of a range of dermatological conditions. Self Care. 2013;4(4):87–89.
    1. Brata C, Gudka S, Schneider CR, Everett A, Fisher C, Clifford RM. A review of the information-gathering process for the provision of medicines for self-medication via community pharmacies in developing countries. Res Social Adm Pharm. 2013;9(4):370–383.
    1. Aradottir HA, Kinnear M. Design of an algorithm to support community pharmacy dyspepsia management. Pharm World Sci. 2008;30(5):515–525.
    1. Bertsche T, Nachbar M, Fiederling J, et al. Assessment of a computerised decision support system for allergic rhino-conjunctivitis counselling in German pharmacy. Int J Clin Pharm. 2012;34(1):17–22.
    1. Cantrill JA, Weiss MC, Kishida M, Nicolson M. Pharmacists’ perceptions and experiences of pharmacy protocols: a step in the right direction? Int J Pharm Pract. 1997;5(1):26–32.
    1. Watson MC, Bond CM, Grimshaw J, Johnston M. Factors predicting the guideline compliant supply (or non-supply) of non-prescription medicines in the community pharmacy setting. Qual Saf Health Care. 2006;15(1):53–57.
    1. Schneider CR, Gudka S, Fleischer L, Clifford RM. The use of a written assessment checklist for the provision of emergency contraception via community pharmacies: a simulated patient study. Pharm Pract (Granada) 2013;11(3):127–131.
    1. Schneider CR, Emery L, Brostek R, Clifford RM. Evaluation of the supply of antifungal medication for the treatment of vaginal thrush in the community pharmacy setting: a randomized controlled trial. Pharm Pract (Granada) 2013;11(3):132–137.
    1. Shealy KM. Mnemonics to assess patients for self-care: is there a need? Self Care. 2014;5(1):11–25.
    1. Akhtar S, Rutter P. Pharmacists thought processes in making a differential diagnosis using a gastro-intestinal case vignette. Res Social Adm Pharm. 2014 Sep 28; Epub.
    1. Rutter PM, Patel J. Decision making by community pharmacists when making an over-the-counter diagnosis in response to a dermatological presentation. Self Care. 2013;4(6):125–133.
    1. Iqbal N, Rutter P. Community pharmacists reasoning when making a diagnosis: a think-aloud study. Int J Pharm Pract. 2013;21(S2):17–18.
    1. Tan AC, Emmerton L. Non-prescription medicines: current issues in Australian community pharmacy. Int J Pharm Pract. 2009;17(4):207–213.
    1. Bissell P. Variation within community pharmacy. 2: responding to the presentation of symptoms. J Soc Adm Pharm. 1997;14(2):105–115.
    1. Emmerton L, Shaw J. The influence of pharmacy staff in non- prescription medicine sales. Int J Pharm Pract. 2002;10(2):101–106.
    1. Stevenson M, Taylor J. The effect of a front-shop pharmacist on NPM consultations. J Soc Adm Pharm. 1995;12(3):154–158.
    1. Ward PR, Bissell P, Noyce PR. Medicines counter assistants: roles and responsibilities in the sale of deregulated medicines. Int J Pharm Pract. 1998;6(4):207–215.
    1. Hassell K, Seston EM, Schafheutle EI, Wagner A, Eden M. Workload in community pharmacies in the UK and its impact on patient safety and pharmacists’ well-being: a review of the evidence. Health Soc Care Community. 2011;19:561–575.
    1. Can you trust your local pharmacy’s advice? Which? investigation finds best and worst companies. Which? 2013. May 20, [Accessed March 17, 2015]. website on the Internet. Available from:
    1. Morley A, Jepson MH, Edwards C, Stillman P. What do doctors think of pharmacists treating minor ailments? Pharm J. 1983;231:387.
    1. Spencer JA, Edwards C. Pharmacy beyond the dispensary: general practitioners’ views. BMJ. 1992;304(6843):1670–1672.
    1. Erwin JN, Britten N, Jones R. General practitioners’ views on over the counter sales by community pharmacists. BMJ. 1996;312(7031):617–618.
    1. Bayliss E, Rutter P. General practitioners’ views on recent and proposed medicine switches from POM to P. Pharm J. 2004;273:819–821.
    1. Rutter PM, Tsang G. Nurse independent prescribers’ views on recent and proposed medicine switches. Nurse Prescribing. 2011;9(4):195–199.
    1. Aronson JK. From prescription only to over-the-counter medicines (‘PoM to P’): time for an intermediate category. Br Med Bull. 2009;90:63–69.
    1. Self Care Forum The self-care continuum. [Accessed June 16, 2015]. Available from:

Source: PubMed

3
Subskrybuj